Life After ACL Injury – Risk for Secondary Injury in Youth Athletes

“If You Have an ACL injury and Undergo Surgery, is There a Risk for Secondary Injury in Youth Athletes?”

Understandably, many youth athletes, parents and physicians are concerned with secondary injury, especially following common injuries like an ACL injury. Youth athletes that undergo surgery following an ACL surgery should receive the best outcome for their future. Many athletes fear recurring injuries due to a previous surgery or injury.

ACL Re-injury in Youth Athletes There was an excellent review published in the July, 2016, American Journal of Sports Medicine that was performed at the Cincinnati Children’s Hospital. Dr. Amelia Wiggins was the lead author.

The study was a systematic review of literature from PubMed from 1966 to July 2015. PubMed is the U.S. National Library of Medicine National Health Institutes of Health. This online resource comprises more than 26 million citations from various biomedical journals, books and articles.

The authors reviewed all of the articles and selected only specific articles that met criteria for secondary injury in young athletes. Researchers reviewed 19 articles and used this data to formulate the bases of their research project.

Research Findings Re: ACL Injury in Youth Athletes

The researchers found that the second total ACL re-injury rate was 15 percent. Of this 15 percent, 7 percent of these injuries occurred on the same side of the body. Eight percent were on the opposite side of the body as the previous injury. The secondary ACL injury rate for both the same leg and the opposite leg for patients younger than 25 years was 21 percent. The secondary ACL injury for athletes that returned to sport was 20 percent. Researchers combined these risk factors and athletes 25 years and younger that returned to sports have a secondary ACL injury rate of 23 percent.

Researchers concluded that the combined data indicated that nearly one in four young athletes that have undergone ACL treatment will face another ACL injury in their career, most likely early after returning to play.

The authors found a high rate of secondary injury in young athletes returning to their sport after an ACL reconstruction. This equates to a 30 to 40 times greater risk of an ACL injury compared with uninjured adolescents.


This article indicates that different activities and rehabilitation are increasingly important to prevent acl injury in youth athletes. Physicians suggest that patients undergoing acl reconstruction focus on activity modification, improved rehabilitation, and follow return to play guidelines. Additionally, it’s important to use integrative neuromuscular training to help the athlete safely reintegrate into sport and reduce the risk of a second injury for this at-risk population.

Interested in more info about ACL injuries? Louisville orthopedic surgeon and sports medicine physician Dr. Stacie Grossfeld can help. For more information about ACL treatment and return to play for athletes, call Orthopaedic Specialists at 502-212-2663.